Issue spotlight: Comparative effectiveness research

How can we be sure that our health dollars are spent wisely, not wasted on treatments that don’t help patients?  Comparative effectiveness research – studying whether one treatment or drug is more effective than another – has the potential to help doctors make better decisions that will help patients have better outcomes of care.

Who is for it?

The government has been funding comparative effectiveness research -- for some time. The American College of Physicians says, “This information is necessary for our members to work with their patients to develop effective, patient-centered treatment plans and for all health care payers to ensure value in their health care decisions.” The American Medical Association also supports it. Both President Obama and Republican candidate Senator John McCain called for more of it during the 2008 campaign.

Who is against it?

Drug companies, manufacturers of medical devices, some conservatives (including Rush Limbaugh, who has given the issue some visibility).

What are the arguments for it?

By some credible estimates, as much as 30 percent of health spending is wasted on treatments that don’t help the patient.  We all pay for this, through our premiums and our taxes. According to information compiled by the Institute of Medicine, doctors do not have adequate access to adequate information about the relative effectiveness of various treatment options:

• More than 50% of patients with diabetes, hypertension, tobacco addiction, hyperlipidemia, congestive heart failure, asthma, depression and chronic atrial fibrillation are currently managed inadequately.
• The lag between the discovery of more effective forms of treatment and their incorporation into routine patient care averages 17 years.
• 18,000 Americans die each year from heart attacks because they did not receive preventive medications, although they were eligible for them.

What are the arguments against it?

Some conservatives argue that it could lead to government dictating to doctors how to treat their patients.

What does CWA think?

We don’t want government telling doctors what to do, but that’s not what comparative effectiveness research means.  What we do want is someone other than drug reps, medical device manufacturers and other parties that have a financial interest in particular treatments or procedures providing doctors and patients with accurate information on what treatments work best.  We want an affordable system that delivers the best quality care.  Our system is already so expensive we can’t afford not to know how best to spend our health care dollars.